Is my baby at risk of getting measles?

When your baby is about one year old you'll be offered the MMR as part of his routine immunisations (PHE 2017e). The MMR is about 90 per cent effective in protecting babies against measles, and also provides protection against mumps and rubella (PHE 2017c).

A second dose (booster) will be offered when your baby is three years and four months old, or soon after (PHE 2017e). After this preschool booster, 95 per cent of children are protected from measles (PHE 2017c).

If your baby hasn’t had the MMR, he does have a small chance of catching measles. It’s still rare for babies in the UK to catch measles, even though cases of the disease have gone up and we are no longer considered a "measles-free" country (PHE 2019a).

In 2017, the World Health Organisation (WHO) declared that the UK had officially eliminated the disease (PHE 2019b). Elimination means that vaccine coverage is so good that there are so few cases of measles it can't easily spread outside clusters of infection (PHE 2019a). However, the number of confirmed cases increased significantly in 2018, resulting in the WHO withdrawing our measles-free status in August 2019 (PHE 2019b).

This happened because there are areas of the UK where fewer parents are taking their babies to have the MMR vaccine. As a result, the numbers of confirmed measles cases in England and Wales have more than trebled, from 284 in 2017, to 991 in 2018 (PHE 2019b).

How is measles spread?

Measles is caused by the highly infectious rubeola virus. When someone who has the virus sneezes or coughs, tiny droplets containing the virus spray into the air. The droplets stay active for a few hours in the air, or on a surface (NHS 2015b). If your baby comes into contact with these droplets, he can become infected (NICE 2013, PHE 2017b).

Being in the same room for at least 15 minutes with someone who has measles, or having face-to-face contact with them, is enough to expose your baby to the virus (PHE 2017b). This could be a situation where you don't realise there's someone with measles nearby, such as in a doctor's surgery waiting area, or at the accident and emergency department of a hospital (PHE 2017b).

If your baby hasn’t been immunised, and hasn’t had measles before, he's likely to catch it if he is exposed to it. Nine out of 10 unvaccinated children who come into contact with measles will catch it (OVG 2017).

What are the symptoms of measles?

A more obvious early symptom is small, grey-white spots inside your baby's mouth (NHS 2015b). The spots may look like grains of sand or salt (NICE 2013).

Between two days and four days after early symptoms appear, a red-brown blotchy rash develops. The rash will first show on your baby's head or upper neck, before spreading to the rest of his body (NHS 2015a, NICE 2013, PHE DH 2013). As the rash appears, your baby's fever may rise to as high as 40 degrees C (NICE 2013).

The spots will spread over his body and develop a bumpy texture. The rash may be slightly itchy (NHS 2015b), and will last for about five days (NICE 2013). As it fades, it will turn a brownish colour and leave your baby’s skin dry and flaky.

What if my baby's exposed to measles before he's had his MMR?

Call your doctor if your baby hasn’t had the MMR vaccine, but has been exposed to measles (PHE 2017c), or you live in an area where there's a measles outbreak.

Your doctor will want to know about it. Measles is a notifiable disease, which means that he'll need to report it to the government (NICE 2013).

It can take about 10 days for measles symptoms to show (NICE 2013). The time between someone being infected with measles and then showing symptoms is called the incubation period (PHE 2017b).

Treatment will work best for your baby if he receives it in the early part of the incubation period (PHE 2017c), so take him to the doctor within three days (72 hours) of being exposed to measles.

Your doctor will make sure your baby is seen as a priority, but you'll have to book an appointment first (NHS 2015a). The surgery will need to plan your visit to minimise the chances of measles spreading. You may be asked to wait in a side room to see the doctor, or you may be offered an appointment at the end of the day (NHS 2015a, PHE 2017b). For the same reason, don't take your baby to a walk-in clinic.

The type of treatment the doctor will recommend depends on your baby's age:

If your baby is younger than six months

Your doctor can give your baby an injection of a substance called human normal immunoglobin (HNIG). HNIG gives your baby a short-term boost of measles antibodies, which can help to make his symptoms less severe (PHE 2017a).

At six months or less, your baby is too young to have the MMR. He'll have some of your measles antibodies in his system from the time he was in your womb (uterus). These inherited antibodies are not strong enough to stop him getting measles, but they are strong enough to interfere with how well the MMR works to protect him (PHE 2017a).

If your baby is between six and eight months

The type of treatment depends on how close your baby has come to the virus:

Your baby should have HNIG if he's been in the same room as someone with measles. HNIG is a better treatment for babies of this age who are at the highest risk of catching the disease.

Your baby should have the MMR if there's been outbreak of measles in your area, but your baby hasn't come into direct contact with the disease.

(PHE 2017a)

If your baby is nine months or older

Your doctor can give your baby the standard MMR vaccine, ideally within three days of exposure (PHE 2017a).

If your baby was born prematurely, he can still have HNIG before six months, or the MMR after six months (PHE 2017a).

Even if your baby has had measles, or an early dose of the MMR vaccine, he will still need to be immunised at 13 months, in line with the childhood vaccination programme (NHS 2015b, PHE 2017c, PHE DH 2013).

The MMR works best if it's given at around 13 months, because by then the antibodies your baby picked up from his time in the womb should have disappeared from his body (NHS 2015b).

How should I care for my baby if he has measles?

Once your baby has measles symptoms, the best you can do is keep him comfortable as the illness runs its course (NHS 2015b, NICE 2013). Measles is a virus, so it can’t be treated with antibiotics (NICE 2013). Your baby should get better within a week or so (NHS 2015b, NICE 2013).

Here’s what you can do to make your baby more comfortable, and to speed his recovery:

Make sure your baby gets plenty of rest.

Keep him away from his childcare setting and other children until at least four days after he develops the rash (NHS 2015b, PHE 2017d).

Give your baby infant paracetamol or infant ibuprofen to ease his fever and aches and pains. You can give your baby infant paracetamol from two months if he was born after 37 weeks and weighs more than 4kg (9lb) (MHRA 2011). You can give him infant ibuprofen if he is three months or older, and weighs at least 5kg (11lb) (MHRA 2016). Ask your pharmacist or doctor if you’re unsure about the dosage.

To ease your baby’s cough, place a bowl of steaming water in his room to create humidity. Cough medicine won't help his cough, and may even cause unwanted side-effects, such as an allergic reaction (NHS 2009). If he is one year or older, you could give him honey and lemon. Mix one teaspoon of lemon juice with two teaspoons of honey in a glass of warm water. (NHS 2015b)

If your baby is having trouble drinking, or eating, because of a blocked nose, you could try nasal saline drops. These drops can help to thin mucus (NHS 2009). They're only worth trying if your baby tolerates them well, though. Drops are probably not worth it if they just upset your baby.

Can measles cause any complications?

Most babies and children recover from measles without any complications. However, complications are common. One child in 15 with measles will develop complications, and babies under one year are particularly vulnerable (NHS 2015a).

Take your baby to the doctor if he develops any of the common complications of measles. These include:

infections of the chest and airways (respiratory system), such as bronchitis, croup, or pneumonia

(NHS 2015b)

Common complications can turn occasionally serious, so keep a close eye on your baby. If he seems to find breathing painful, is struggling to take breaths, or starts to cough up blood, call 999 for an ambulance, or take him to the accident and emergency (A&E) department of your local hospital (NHS 2015b).

It's also common for babies and children with measles to have a febrile convulsion or seizure (NHS 2015b). If this happens to your baby, and he hasn't had a convulsion before, call an ambulance, or take him to A&E (NHS 2016).

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